Best Practices for Effective Physician On-Boarding
You’ve successfully recruited the physician you need to serve your community. What comes next? The hiring process is just the first step in retaining these professionals you have worked so hard to recruit. Equally important is physician on-boarding — the process of familiarizing and orienting physicians to a new healthcare facility or practice, and to the culture of your organization. On-boarding introduces new physicians to the community, integrates them into the medical staff, helps them establish their practice and achieve a firm financial foundation in the first year.
The case for on-boarding
An effective on-boarding process can help retain physicians in an increasingly competitive and challenging environment. The candidate pool is shrinking and the number of medical students continues to decline. In the year 2020, the expected shortage of practicing physicians is estimated to be 91,000.
Physician replacement costs are significant. The average cost to turn over a physician is $1.2 million. This impacts hospital revenue and patients’ perceptions of care. Replacing the productivity of a retiring internist will require 1.6 younger physicians, according to a 2014 Truven Analytics study. A systematic, well-organized on-boarding process can increase retention (avoiding the costs associated with physician replacement), stabilize access to care, and reduce outward migration.
Lack of an organized on-boarding process has added ramifications: physicians could lose confidence in the hospital or their group by a perceived lack of interest in their success resulting from poor on-boarding; and a delayed practice ramp-up period would increase the time needed to see positive ROI on an income guarantee or employment.
Here are some best practice tips to improve the physician on-boarding process.
Create an effective on-boarding program customized to your facility. Survey existing physicians to obtain feedback about the current on-boarding program and create a small task force to outline an ideal state process. Assign project leaders to assemble support teams including community members and volunteers, and measure results.
Set up Phase I (signed agreement to orientation) and Phase II (orientation to 90 days) action plans.
- Phase I should include the completion of credentialing and enrollment; weekly communication from a designated hospital liaison; and personal/family assistance, such as house hunting, connecting with local service providers (Internet, phone, etc.) and getting kids in school. Welcome the entire family to the community.
- In Phase II, complete the orientation process and review guidelines and expectations; market physicians to the community and other providers; and help integrate the physician and their family into the community by linking them to resources, groups and organizations.
Additional best practice tips include:
- Integrate new providers into your culture. Tell them what makes your culture and mission unique. Explain your hospital/health system goals.
- Ensure basic resources are provided ‘day 1,’ including a lab coat, prescription pad, an ID badge and a tour of the facility.
- Give them time to set up their office and meet their team before they start seeing patients.
- Bring in their spouse to help them fill out benefits elections.
- Give them flu shots and vaccinations etc. to meet 100 percent of employee wellness goals.
- Have hospital leaders visit/eat lunch with them during orientation.
- Train them on the EMR/how to log in to email/how to access resources; have them complete education modules during orientation.
- Assign an administrator as a point of contact for each new physician and have them meet regularly during the first year.
- Send out a postcard to your primary and secondary service area introducing the new physician. Include photos, address, phone number, and a ’now accepting patients’ message.
Making it work
Physician on-boarding doesn’t “belong” to the CEO alone. It should be a shared responsibility across hospital leadership, HR, the group or physician the doctor is joining, physician leadership, community members such as Chamber representatives, and hospital Board members.
On-boarding is the benchmark for physician engagement. An effective process can reduce physician turnover and recruitment costs, establish continuity of care, increase hospital productivity, and positively affect patient and employee satisfaction scores.
- Read about CHC Physician Recruitment Strategies for community hospitals.
- Read the CHC Physician Recruitment services overview.